This article on the BBC News website caught my eye today. Margaret Watt from the Scottish Patients Association saying that drunken A&E patients should pay for their treatment, because they often abuse doctors and nurses (so because some do this, we charge everyone?) There are a few questions that this raises.
Firstly, I can't really see how the scheme would be workable in practice. Would hospitals attempt to charge people at the time of treatment, or would they have a bill sent to them a few days later? The first option is a non-starter, since most people being admitted will already have spent all their money getting drunk in the first place, plus they might get rather irate at being told to stump up money, and the second option seems a little unfair, particularly if you receive a bill for something you don't even remember...
Secondly, how would they determine who to charge? Would it be anyone who is visibly drunk, or would you be breathalysed? Would it just be people who had drank to excess and needed their stomach pumped or something along those lines, or would it also include those who had become victims of violence? It would seem a bit unfair to charge extra to someone who has been beaten to a pulp while drunk, but some might argue that they wouldn't have gotten into that state in the first place if they hadn't already been intoxicated.
Thirdly, it brings into question what the point of the NHS is. Is it to ensure universal free healthcare without question of circumstance, or is it to provide free healthcare for the deserving only? This idea is effectively saying "drunk people only have themselves to blame, so the burden of provision should be on them, not the taxpayer." I'm not sure I completely disagree with this notion, but it's a dangerous road to go down. You could make a similar argument towards mountain climbers and mountain rescue services - should the taxpayer really be paying for people to be rescued because they've decided to embark upon a dangerous hobby, or should they be made to fund rescue services themselves? Similarly, when these people come into hospital with injuries incurred because they've chosen to do something risky, should the hospital charge them for needlessly using up their resources? Where would it stop? Where would the line be drawn between people who were effectively "asking for it" (because that's essentially what we're talking about here), and people who just happened to be the victim of an accident?
I'm maybe jumping the gun a bit, but I could see this being the road to an American-style healthcare system, with people needing to take out insurance in order to be treated at hospitals. I don't think any of us want that.